Surgeon’s dilemma: should I save patient’s life at any cost?

Abstract

Every doctor practicing treatment in the field of medicine may be confronted with a serious question: should I save my patient's life at any cost? If a doctor resigns from emergency procedures, he/she will risk the patient's death. However, if he/ she decides to proceed regardless of a Jehovah's Witness patient's statement of will, in which he or she refuses transfusion, he/she takes a risk of illegal medical intervention. There is neither an easy answer, nor a serious solution, thus the only way is to choose the lesser of two evils. Notwithstanding legal issues, there are still ethical problems, which result in an internal dilemma for a doctor. StreszczenieKażdy lekarz może stanąć w obliczu dylematu: czy powinienem próbować ratować pacjenta za wszelką cenę? Jeśli lekarz zrezygnuje z procedur medycznych wykonywanych w stanach nagłych z uwagi na przekonania religijne pacjenta, może ryzykować jego śmiercią i tym samym naraża swoje zobowiązania etyczne. Jeżeli jednak zdecyduje się kontynuować proces leczniczy obejmujący transfuzję krwi, niezależnie od tego, czy pacjent jest świadkiem Jehowy, który odmawia transfuzji, podejmuje ryzyko nielegalnej interwencji medycznej. W tego rodzaju przypadkach nie ma ani łatwej odpowiedzi, ani prostego rozwiązania, natomiast jedynym rozwiązaniem wydaje się wybór mniejszego zła. Niezależnie od aspektów prawnych, aktualne i istotne pozostają problemy etyczne, które wywołują u lekarza wewnętrzny konflikt.

Between Autonomy and Paternalism: Attitudes of Nursing Personnel Towards Jehovah’s Witnesses’ Refusal of Blood Transfusion

“…Thus, this study shows that as JW patients’ refusal of transfusions of certain blood products creates tension between such basic bioethical principles as respect for patients’ autonomy, beneficence, non-maleficence and justice [ 50 ], it often creates conflict between HCPs’ obligation to care and the duty to respect different perspectives of the patient [ 7 , 10 , 23 , 51 , 52 ]. At the same time, it shows that the ethical and legal issues arising from the case of a patient who refuses blood transfusion based on their religious beliefs are particularly conspicuous when it comes to adolescent patient.…”

“…This is particularly important in countries such as Poland, where both multidisciplinary teams and intercultural therapy are only in development, and HCPs’ awareness of non-blood management techniques and risks related to blood transfusion is inadequate. Consequently, they often lack information about so-called bloodless medicine which should be integral part of co-ordinated care, and pay insufficient attention to communication with the JW patient and their family [ 51 , 52 ].…”

Koronawirus — wybrane aspekty prawne dotyczące rozterek lekarzy

“…Many of the physicians' choices which they have to make in everyday practice encompass choice of the lesser evil, as none of the solutions is cost-free [1]. Nevertheless, under conditions of common battle, such medical quandaries may have huge medical consequences and include legal motifs.…”